OK, I Have Breast Cancer. Now What? A Step-by-Step Guide to Treatment

You had a “bad” mammogram. You thought, OK, it’s probably nothing, even though they want me to have a biopsy.

You had a biopsy, and waited for the results. You thought, lots of people have breast lumps, and they always turn out to be nothing.

Then you got the call. And heard the words.

You have breast cancer.

That was a few days ago. Maybe a week. Since then, you’ve been convinced you were going to die. Then certain you’d be fine. Then found yourself sobbing because you’d never see your grandchildren. Your family’s in a (shocked) uproar; you’re gradually figuring out how to tell people; you’re trying to plan your next steps.

But it’s hard to plan if you don’t know what comes next, isn’t it? I mean, how debilitating is this breast cancer thing? How much time will you have to take off from work? Will you be in bed? Feel fine? Be able to drive, pick your 1-year-old up out of his crib, make love?

Breast cancer has as many different incarnations as there are women who deal with it; we all experience our own personal journey. But thankfully, there’s a common path we follow, a treatment sequence that usually varies only in its details.   

I can’t tell you how you’ll react to chemo, how much pain you’ll have after your mastectomy, or whether or not radiation will exhaust you. But I can at least help you plan out the next chunk of your life by sharing with you a general timeline of events for the next few months.

Ready? Let’s begin.

First step: the surgeon
The first thing you’ll do is simple: wait. For an appointment with either a breast surgeon, or an oncologist. (Since most women see a surgeon first, that’s the path we’ll follow here.)

Although you probably want that tumor removed from your breast RIGHT NOW, doctors know that breast cancer isn’t a medical emergency. Except in rare cases, it’s slow growing, and waiting several weeks for surgery isn’t a deal-breaker. Really. It’ll make you crazy, but you’re not the only patient at the hospital, and you simply have to wait your turn to see a surgeon.

Surgery options
When you finally meet your surgeon, (s)he will probably offer you two options: breast conservation surgery, a.k.a. lumpectomy. Or mastectomy – total removal of your breast. The surgeon may have a recommendation; or the decision may be left entirely up to you.

If you decide on mastectomy, you’ll also have to decide whether you want reconstructive surgery. If you opt for reconstruction, you need to decide on the timeframe, and the type.

WHEW! Once you get past all the decisions, your surgery will be scheduled. And then you’ll wait again; possibly for weeks. Surgeons are busy; your cancer isn’t an emergency. Patience is a virtue… and oh so difficult.

Timeframe
The amount of time it takes to remove a tumor from your breast, and possibly harvest a few underarm lymph nodes at the same time, can vary from about an hour, to upwards of 8 to 9 hours (f you have reconstructive surgery at the same time).